双核素心肌断层显像方法20

Clinical course
Cardiac catheterization : Three coronary vessels. There was a 80% LAD lesion, 90% narrow of the left circumflex artery and 50% lesion in the right coronary artery . One month later the patient underwent CABG.
双核素心肌断层显像方法20
此处添加副标题内容
双核素心肌断层显像方法
仪器
◆采用 elscint varicam 双探头SPECT (GE公司提供），配备超高能准直器 (UHEC)。
◆双探头采用90度垂直位(L-mode) 进行分步采集。
体位
◆患者取仰卧位，双手抱头充分暴 露心前区。
◆探头尽量贴近患者以最大限度增 加计数，减少噪声。
Case 1 LJZ
History : 67 – year - old male, 2 years history of progressive typical exertional angina and inferior myocardial infarction. Cardiac risk factors included age, known history of CAD. The resting ECG revealed sinus bradycardia and evidence of an old inferior myocardial infarction.
Case 4 GTB
A 58-year-old man presented with mild congestive heart failure 1 year. He had often experienced a chest tightness, and shortness of breath. Cardiac risk factors included age and hypercholesterolemia. The resting ECG revealed LBBB. The resting MIBI - FDG SPECT(DISA) was performed.
采用滤波反投影法进行重建，分别得到 水平长轴、短轴及垂直长轴三个断面的 图象；滤波函数采用butterworth,截止频 率为0.45, 权重值为4.5。
血糖调节
静脉注射99Tcm-MIBI20mCi，45分 钟后测定患者的血糖浓度，将血糖浓度 控制在7.9-8.8mmol/L之间。如果患者 血糖浓度低于7.8mmol/L需要口服葡萄 糖补充，如果血糖浓度高于8.9mmol/L 则需要皮下注射胰岛素降低血糖浓度。 在血糖控制后10-15min，静脉注射 18F-FDG 6-8mCi，一小时后显像。
according to the plasma glucose.
Case 2 WCD
A 62-year-old female with no past cardiac history presented with a 6 month history of exertional chest pain with both typical and atypical feature. Cardiac risk factors included hypercholesterolemia, family history of CAD. The resting ECG revealed normal.
采集条件
采 集 程 序 为 系统 自 带双核素断层采集 程序 ( HEI/MIBI ECT Dual Isotope) ; 能 峰为140kev 及 511kev、窗宽20%；矩阵 64×64 ；采集时间为 30-35秒；探头旋转 角度为90度(由左前至右后共180度）、每 3度一帧分步采集。
处理条件
Clinical cour百度文库e
Cardiac catheterization revealed a 100% LAD lesion and 90% narrowing of the right coronary artery. The patient underwent successful coronary bypass surgery .
DISA imaging protocol
MIBI Plasma glucose FDG
DISA
0′ 40′
60′
120′(min)
Plasma glucose 140~160mg%.
Plasma glucose level 140mg%, 50-75g glucose.
Diabetes mellitus, Insulin was subcutaneously injected
Hospital course
Cardiac catheterization : LAD 90% , LCX 80%, RCA 60%
Clinical diagnosis: CAD Angina pectoris
The patient underwent CABG.
Case 3 LJX
44-year-old male without known CAD presented with a 3 year history of atypical chest pain and dyspnea on exertion. Cardiac risk factors included cigarette smoking. No history of hypertension , diabetes mellitus . ECG revealed nonsepecific T wave abnormalities. Echocardiography revealed dilated left ventricle and atrium.Severe left ventricular hypokinesis. LVEF=25%